Article Submission Guidelines for Practice Management, EHR, Glaucoma, and Managed Care

Exclusive Date: July 31, 2013

A Practical Guide to Working with an Office Manager

 Sponsor: Alcon® - DAILIES® AquaComfort Plus®

Many optometrists are unsure about how to hire and train an office manager. Here is a very practical look at why your practice needs one and how to find a good one.

Yes, you need a manager
An office manager is a job title that can have vastly different duties depending on the size of the practice. In a smaller practice, the job is a dual-role, such as manager/receptionist or manager/optician. In a larger practice, the manager will hardly ever work with patients at all because there is so much administrative work to do. The management role typically changes slowly over time as the practice grows.

I believe it works best to design the practice from the start to operate like a large, successful practice, so why not appoint a staff member as manager early on? The optometrist will be heavily involved in management when the practice is smaller, but the operation of the office will be built around the presence of a manager and everyone becomes comfortable with that concept. The doctor increasingly delegates more tasks as the practice grows and as more staff members are hired. This optimum delegation includes optical dispensing, clinical data collection and office administrative duties. This builds a system where the practice is not solely dependent on the doctor/owner. Eventually, when associate ODs are hired, the practice can function just fine without the doctor/owner being present.

Qualities of a good manager
Many people think a good manager is a powerful personality who will demand great work from the staff, but that type is not what I'm looking for. I want a person who has compassion and empathy for staff members and who will be patient and understanding as we work toward our practice goals. Staff members often need someone who will listen and care as they vent some frustrations from the job. We are not operating a factory; we take care of patients who trust us with potentially serious eye problems. We need a leader who can inspire the staff to have happy attitudes and great morale. We need a positive office culture.

Additionally, I am looking for a manager who understands customer service and is as passionate about it as I am. Many managers are somewhat protective of the practice and they try to be sure that we are not taken advantage of by unreasonable people in the general public. I understand the philosophy, but it tells me that the person who feels that way does not get it. I want a manager who will let the patient win and one who can say the words "I'm sorry" when the situation calls for it. My manager and I understand that the unreasonable people are really no different than you and me when you look at things from their point of view. That is how large, successful practices are built.

Of course, I can list many other traits of a good manager, most of which are common sense, but the two traits above will get you off to a great start.

Manager duties
The actual duties assigned to the manager should gradually evolve to include increasingly more important tasks as the owner gains confidence and trust. There is no handbook for this, but here is a list of jobs that good managers perform:

  • Supervise and direct the staff. This is a big one and it can't work unless all staff members know that the manager is their boss. It can be an awkward moment, but the doctor/owner must tell everyone that the manager has the authority to tell them what to do. Without that authority, which can only be given by the practice owner, the manager can't be effective. The more you hide that authority with vague terms like office coordinator, the less cooperative employees will be. Staff members need to be supervised. It would be great if we could simply share our vision of the practice with the entire staff and they would carry it out, but in reality, most employees look out for their own self-interest first. The manager must look out for the best interest of the practice.
  • Staff management such as scheduling, training, remediating and refereeing disputes. Also, managing requests for vacation, days off, sick days, and to leave early.
  • Supervise billing and serve as a back-up to the insurance coordinator. I never like to see an important task in a practice that only one person knows how to do. Staff members may try to protect their turf in some areas, but the manager should insist on learning it as well.
  • Supervise the handling of payments to the practice including reconciliation of the cash drawer with the daily production report and bank deposits. The practice owner should also receive a report and bank receipt every day that provides a paper trail.
  • Assist with bookkeeping and accounts payable. Again, the practice owner should supervise and approve all payments to suppliers, but the manager can do much of the work.
  • Marketing the practice. This can include recall and many other projects.
  • General administration. There is so much here I can't list it. It becomes obvious if the owner simply thinks... what would happen to the office if I were not here?

Best wishes for continued success,

Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week